My health insurance is with HUMANA, and I have received several messages from them denying my claims because my “service provider” isn’t in their network.
Before I even went to my neurologist, pyschiatrist, orthopaedist (for the broken leg) we made SURE those people were in my network and they only all charged me a 40 dollar co-pay!
If they hadn’t been, I am SURE I would have had to pay for everything out of pocket.
So I replied to Humana asking them why they were denying my claims, and I just got back a message telling me they could not help with “investigating this matter” because I was too “vague” with my inquiry. They want dates, provider names and what I was/am being treated for.
Huh?
THEY sent ME those messages of denial!
They should already know this, right?
Anyone else having this problem, and what agency is available to help cut this shit out?
Thanks!
Q
Sounds to me like you need to send copies of their pre-approval of your neurologist, psychiatrist, and orthopedist, copies of any ‘courtesy’ bills they (the doctors) sent you when billing Humana for you, and copies of the denial notices. If you don’t have courtesy copies, you may need to get something from their offices on what procedures they used.
If you don’t get satisfaction from your claims people, by sheer coincidence I had occasion to look up the adaptive reuse of the Old Belknap Hardware Bldg. in Louisville by Humana, so I knew right where to go for their corporate address:
Humana Inc.
500 West Main Street
Louisville, KY 40202
1-800-486-2620
Thanks, Poly. I will follow up on your suggestions (even though it shouldn’t be necessary, right?).
Luckily, I still have enough mind to write meaningful words (I recently got LL Bean to honor their “guaranteed.period” guarantee, after a whole year of haggling with their customer service department about some returns, by writing a letter to their CEO - registered mail), so if it is needed, their corp is about to get some mail from me they are going to need tongs to read.
Thanks again, Polycarp!
Quasi
My situation doesn’t really help you but I had a stalling insurance company too. I had to send in pharmacy receipts for reimbursement and frequently had to send them two or three times (“we never received those”). The problem went away when I started sending stuff certified mail.
I think your best bet is documentation (actual bills from the doctors’ offices, the denial of claims forms, etc.), sending copies of that stuff certified, and tenacity.
Or, what Poly said. 
Should I really have to do that, kids?
Should any of us???
Recently I had to come to my Doper Family to ask for help, and it was given in abundance!
NOW, this dad-blasted insurance company is wanting MORE interest on their MONEY???
I ain’t GIVIN’ them a friggin’ CENT!
In addition, I am NOT going to do their “leg-work” for them!
Thannks, kiddos, but I have enough paperwork to keep up with.
B~